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Propecia Linked To Serious Side EffectsRecent studies are showing that attempts to stop and reverse hair loss might backfire on the men who try them. The one hair restoration method that is at the center of this controversy is Propecia (also known as Finasteride and Proscar). This drug was highly touted as one of the most effective treatments for hair loss in a Dateline NBC special on hair restoration products and procedures.

The NBC Dateline special focused on results after one year of faithful application of the various procedures, drugs and treatments, including hair transplants, laser combs and Minoxidil or Rogaine. Propecia received the highest marks and was recommended to be used in conjunction with other approaches for maximum benefit. But no mention was made of the darker side effects of this medication.

The March issue of the Journal of Sexual Medicine featured studies by Abdulmaged M. Traish, PhD, a professor of biochemistry and urology at Boston University School of Medicine, and Michael Irwig, a George Washington University endocrinologist who specializes in male hormone disorders.

These researchers believe they have discovered a link between the use of Propecia and long-lasting side effects of male impotency or erectile dysfunction, depression and loss of sexual desire. In a small percentage of cases, symptoms persisted even after the medication was stopped. In addition, some men experienced a condition known as gynecomastia, enlarged female-like breasts in men.

Though Propecia’s manufacturer Merck argues that the side effects are very rare and stop after taking the drug, researchers, both here and abroad, are finding that for some these can be long-lasting, even permanent.

For those men, "it’s a life sentence," said Dr. Traish. "No sex. No desire. Potential depression," Traish added.

The drug works by blocking androgen, a hormone proven to block hair growth and an underlying cause of male-pattern baldness. The Dateline Special noted that this condition affects millions, about 2/3 of American males.

But there’s a downside. "We need androgen for erectile function, libido and ejaculation, and for just feeling good," Traish said.

Noting that increasing numbers of patients report ongoing sexual problems after they stop taking the drugs, Traish said, "That’s where the light should be shined."

"I am not worried about those who stop taking the drug and get their life back, (my concern is) about those who stop taking the drug, but they don’t get their life back," Traish said.

In Europe – particularly the UK, Sweden and Italy – the severity of these side effects have been recognized for a long time. A BBC radio special and a Swedish TV station zeroed in on these effects as far back as 2006. Merck has been very familiar with the findings in Europe and were pressured in 2008 to change their warning labels to include warnings that their product may cause irreversible sexual side effects.

From the BBC:

From Sweden:

No such warning exists here. Warning labels and the official Merck Propecia website warn that some men suffer problems such as decreased libido, erectile dysfunction, and decreased ejaculate. However, the company says these problems are unusual – occurring in fewer than 2 percent of men on Propecia – and get better.

"These side effects decreased to 0.3 percent of men or less by the fifth year" on Propecia, the website says. "These side effects went away in men who stopped taking Propecia because of them."

But male consumers and medical doctors have found something else entirely. In addition to Traish and Irwig, Andrew Rynne, a physician in Kildare, OR, posted a warning about Propecia on his website in October. He believes the fraction of men who suffer sexual side effects is higher than 2 percent – but even 2 percent is too high.

"To the uninitiated, it might seem like a low figure," he wrote. "But you are dealing here with a naturally occurring normal male phenomenon called ‘male pattern baldness.’ This is not an illness or a disease. If in an attempt to ‘cure’ it, you are getting a 2 percent rate of serious side effects, then that, quite frankly, is unacceptable."

Millions of men worldwide have taken Finasteride. In 2009, Propecia sales were worth $440 million, while Proscar brought in $290 million.

In the past, men suffering from the ongoing effects of this drug formed their own online support group to warn others about these dangers. But now, some of the men have gone on the offensive, suing Merck in both the United States and Canada.

Connecticut Attorney Edward Jazlowiecki has joined two other firms, in New Jersey and New York, in filing the U.S. suit. "The same mechanism in the hormone system that controls hair loss also controls sexual function and a patient’s mental state, and this drug has had devastating effects and destroyed the lives of men who have taken it," Jazlowiecki said. The suit also claims Finasteride leads to emotional symptoms like anxiety attacks and insomnia that do not go away for years after men stop using the drug.

Jazlowiecki said that one of the plaintiffs in his suit suffered such severe symptoms that his wife left him, and that another plaintiff suffered from a loss of concentration that forced him to drop out of law school. Jazlowiecki’s complaint, filed in U.S. District Court in New Jersey, where Merck’s U.S. headquarters are located, also quotes American and European doctors who have passionately argued against the drug

Traish said doctors need to inform their patients about the potential side effects. "As a physician you have a responsibility to take the time and explain to your patient that maybe not everyone will have these side effects, but you may, and in some cases they are irreversible," he said.

Merck needs to do more to let men know of the serious and potentially permanent side effects from Propecia.

(c) Copyright 2011 Brett A. Emison

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